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      Early outcome after the use of the triceps fascia flap in interposition elbow arthroplasty: a novel method in the treatment of post-traumatic elbow stiffness

      case-report

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          Abstract

          Background: Post-traumatic elbow stiffness (PTES) results in severe interference with the activities of daily living (ADL), affecting mainly young people. Total elbow arthroplasty (TEA) is relatively contraindicated in the young patient and arthrodesis is poorly tolerated. Interposition elbow arthroplasty (IEA) improves the range of motion (ROM) buying time for future reconstructive surgery. While the fascia lata remains the most common material used in IEA, the triceps fascia is a native vascularized tissue, and it does not require a separate incision to harvest. To our knowledge, there are no published studies on the use of this technique of IEA. Method: Sixteen patients with post-traumatic elbow stiffness had IEA with the triceps fascia between January 2009 and January 2017. The ROM was assessed pre-operatively and post-operatively at the 6th and the 24th week. The researchers also evaluated the functional outcome with the Mayo Elbow Performance Score (MEPS) at the 24th week. The data were analysed with the software IBM SPSS Version 20. Results: Nine males and seven females had IEA with the triceps fascia. The mean age of the subjects was 22.8 years (SD = 6.39). The median duration of the stiffness was eight months (range: 2–168 months). Fall was the most frequent cause of post-traumatic elbow stiffness, and the non-dominant side was more frequently involved. Fourteen patients had an intervention at the native bone setters before presentation to the hospital. The mean elbow ROM increased from 16.4° pre-operatively to 97.2° at the 24th week ( p < 0.001), while the mean MEPS improved from 42.5° pre-operatively to 81.2° post-operatively ( p < 0.001). Conclusion: The triceps fascia flap provides an excellent alternative to the fascia lata for IEA without the complications of the donor site morbidity.

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          Most cited references10

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          The stiff elbow

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            Stiff elbow: distraction interposition arthroplasty with an Achilles tendon allograft: long-term radiological and functional results.

            The aim of this study was to evaluate the long-term radiological and functional results of distraction interposition arthroplasty using an Achilles tendon allograft.
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              The evolution of elbow arthroplasty: innovative solutions to complex clinical problems.

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                Author and article information

                Journal
                SICOT J
                SICOT J
                sicotj
                SICOT-J
                EDP Sciences
                2426-8887
                2020
                05 May 2020
                : 6
                : ( publisher-idID: sicotj/2020/01 )
                : 8
                Affiliations
                [1 ] Department of Orthopaedics and Trauma, National Orthopaedic Hospital HA7 4LP Enugu Nigeria
                Author notes
                [* ]Corresponding author: dreciyidobi@ 123456yahoo.com
                Author information
                http://orcid.org/0000-0002-8797-024X
                http://orcid.org/0000-0002-0612-8019
                Article
                sicotj190033 10.1051/sicotj/2020006
                10.1051/sicotj/2020006
                7199511
                32369013
                42174fed-1272-418a-86e1-1980adb9701c
                © The Authors, published by EDP Sciences, 2020

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 March 2019
                : 11 March 2020
                Page count
                Figures: 7, Tables: 2, Equations: 0, References: 10, Pages: 6
                Categories
                Elbow
                Surgical Technique

                elbow,interposition arthroplasty,triceps fascia,post-traumatic stiffness

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